Individual
MR. CHARLES FAZZINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.P.C.
Contact information
Practice address
41 MONTEBELLO RD STE LL1, PUEBLO, CO 81001-1379
(719) 545-2746
(719) 542-9638
Mailing address
41 MONTEBELLO RD STE 202, PUEBLO, CO 81001-1366
(719) 545-2746
(719) 542-9638
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACD.0000024
CO
101YP2500X
Professional Counselor
Primary
LPC.0000092
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26306760
—
CO
Enumeration date
05/22/2007
Last updated
10/02/2018
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